Thursday, April 22, 2010

Earth day healthcare

This post is a continuation of the series looking at the cross-roads of peak oil and healthcare.

Happy anniversary of Lenin's birth, everyone! Yes, the Communist Revolution's leader was born on this day in 1870!

But much more seriously and importantly, happy Earth Day! No matter how cynical you may be about what this day has turned into, you can personally take this time to reflect on your interaction with our Mother. The Buddha felt that we are not distinct from anything, including the earth and the rest of the Universe. So, if you are an intermediate-to-advanced Buddhist, this is a good day to practice oneness. For the rest of us, perhaps we can engage our thoughts to be mindful and notice throughout our day how our actions impact the environment.

And this, as everything does eventually, brings me to healthcare. As I mentioned in my recent post, healthcare system is a tremendously heavy consumer of our natural resources and, as a result, a huge producer of the greenhouse gases. "But it is all in the name of health", you say! Is it really? Dig deep down and ask yourself why you ordered that EKG on the perfectly healthy asymptomatic guy who is starting an exercise regimen, or why you got an MRI for that chronic low back pain? "But look at the strides we have made diagnosing and curing disease", you say! Is this progress not a fair trade-off for the little energy expenditure and a slightly enlarged carbon footprint?

OK, so I have a couple of problems with this argument. First of all, some people would say that the vast majority of the strides we have made in health and longevity are due to such public health interventions as water and sewage treatment, municipal solid waste removal, and the advent of antibiotics. Most of the progress we are making today comes in minute increments at the cost of not only exorbitant dollar amounts, but also of the environmental resources. Not only does this "innovation" require an input of energy and materials, but the waste that its development and manufacturing produces can be staggering, counting not only the green house gas emissions, but also the garbage it yields on the back end. Similarly, the utilization of so much technological "advancement" requires materials, energy, as well as the means of waste disposal. And just because once the trash is hauled away we do not see it does not mean that there is no environmental toll from it.

At this time of healthcare reform, we as a nation are beginning to ask some questions previously regarded as heresy: Are the effects of this intervention worth the healthcare dollars spent on it? I believe that we must go way upstream from the technology being in use on the market, and must start factoring in the environmental toll of its evolution from the genesis of the idea itself. Only this way can we understand the true worth of what we are proposing to use in the name of healthcare.

I know that for most of us to feel one with the world around us is not feasible or desired at this moment. So if chanting Om does not unite us the Universe even for a moment, let us use our well developed minds. The resources of this earth are finite. And even it you do not believe in climate change (though it is difficult for me to imagine how one can believe in God and yet not see the verity of the science behind global warming), perhaps you can start to cultivate a little doubt in your conviction that we can continue as we are with impunity. Perhaps by using our resources mindfully, by asking ourselves several times whether opening that extra needle or ordering that extra head CT is really necessary prior to plunging into action, we can not only forestall the impending oil and climate crises, but also develop a closer relationship with the planet that is ours and our children's home.

Welcome and a disclaimer

Welcome to my blog, "Healthcare, etc."! In this blog I take the perspective of a researcher/policy wonk rather than an individual healthcare practitioner. Therefore, all opinions that I express and generalizations that I make about any issues will in no way be construed as medical advice for individual visitors / readers. All views expressed here are solely my own, and do not represent opinions of any organizations with which I am affiliated. I welcome all comments, but reserve the right not to publish paranoid or abusive rants or overt marketing pitches.

About Me

I am an independent physician health services researcher with a specific interest in healthcare-associated complications and a broad interest in the state of our healthcare system. I am also a professor of Epidemiology at the University of Massachusetts, Amherst.
I am frequently invited to speak about evidence-based medicine, methods and healthcare-associated complications.
My posts have been syndicated on The Health Care Blog, KevinMD,The Healthcare Collective and other sites. They have also been cited in the New York Times. Occasionally you can also find me blogging on the British Medical Journal blog site http://www.doc2doc.bmj.com
If you would like to contact me about my research, blog posts or speaking, please e-mail me at Healthcareetcblog@gmail.com